Application for Course Credit

Please complete all sections, print, and obtain needed signatures before submitting to the Office of the Registrar. In the table below, list all courses for which you are requesting credit. Attach supporting documentation (e.g. exam scores, military transcripts, etc.) to this form.

Student Information

Student Name *

EMPLID *

Course Credit for Prior Learning

Department	Number	Credit	Title

Credits Based On

Check one box, plus attach supporting documents:

Recommendation for Credit — Advisor

Approve Disapprove

Advisor Signature Date

Recommendation for Credit — Dean

Approve Disapprove

Dean Signature Date

* Required fields | Revised 10/15

When the print dialog opens, choose Save as PDF as the destination.